East vs West

The first few chapters of The Spirit Catches You and You Fall Down highlighted a situation that seems inevitable in a country as diverse as the United States. The tension between Lia's parents and her doctors are painfully evident, and a result of Lia's doctors, Neil and Peggy, were genuinely concerned with Lia's health and well-being. Fadiman writes that "unless Lia died, they could see themselves driving to the emergency room in the middle of the night until she was grown up and had graduated to the care of an internist." It is clear that they are dedicated to Lia and all their decisions most likely would be made with Lia's best interest in mind, at least from the doctors' perspective. Fadmin writes that it was "agonizing to watch Lia...[to] fail to receive the treatment [Neil and Peggy] believed might help her lead a normal life." First, it is interesting to note how the use of the word normal is brought up again in medicine. As seen in past readings, it is clear that in medicine there is a clear distinction between what is considered normal and abnormal. The majority of the practice seems to revolve around restoring an individual to normal function, both physically and socially. It seems doctors have taken on the role of fixing patients so that they fit within the confines of society just as much as they help continue life. This is evident in all the intersex unit that was covered in the course, which, like the desires of Neil and Peggy, was to allow their patients to lead a normal life. It is interesting to note that their desire to do so, at this point in the novel, was to fix Lia so she could have a normal life. It was not to save her life (yet). Of course, this becomes an issue later in the novel. But still, the initial motivating factor was to fix Lia so she could be normal, drawing parallels to past units.

It is clear though, that from the perspective of the doctors, they felt that the medication and the treatment they wanted Lia to take was Lia's best bet at dealing with the seizures. Of course, their viewpoint that their treatment was the best is grounded and supported by Western medicine. Certain aspects of Western medicine conflict with Hmong culture and methods, and from the viewpoint of the family and Hmong culture, the decisions of the doctors were not absolutely the best course of action for Lia. It places the doctors in such a difficult position because according to their standards, they know the best treatment for Lia. But, from the perspective of the parents, the doctors overlook things that the parents feel would help out Lia. In addition, they do not understand the principle behind the medication and there is confusion with the medication plan as well due to the language barrier.


The disparity between their cultures illustrates a situation that probably has occurred with individuals of other races and cultures. It creates quite a predicament for both the patient and the doctors. It is interesting to think about cultures other than the Hmong and their potential issues they may have had with medical care. Given the diversity within this country, it is expected that there was already a method in place to deal with situations like Lia's. It seems though, that in order to avoid the miscommunication between doctors and patients , every nuance of a culture must be understood, a difficult proposition for a diverse country with varying population distributions.